Segmentation of the Left Ventricle

  • Eugenio Picano


As with all methods of cardiac imaging, from ventriculography to scintigraphy, the left ventricle can be subdivided into a series of slices or segments for the purposes of echocardiographic examination as well. Since universally accepted standardization is lacking, the number of segments and the echocardiographic views employed for their identification vary markedly in the literature. Segmentation of the left ventricle into 5, 9,10,11,13,14,16, and 20 segments has been proposed[1]. The resolution of the segmental approach is a function of the number of segments; thus, it can range from 20% (in the 5-segment model) to 5% (in the 20-segment model). However, increasing the number of segments, and thus reducing their size, leads to unacceptable complication of the analysis with a greater need for approximation and interpolation. A reasonable trade-off between accuracy and feasibility is represented by the 16-segment model proposed by the American Society of Echocardiography [2]. The wall segments are identified according to internal anatomical landmarks of the left ventricle, in the standard parasternal (long axis and short axis at the mitral, papillary, apical levels), apical (5−, 4−, 3−, and 2−chamber) and subcostal (long axis and short axis) views (Fig. 1). Each segment can usually be visualized in more than one echo-cardiographic section and from different approaches, for a more reliable and complete evaluation of wall motion. As a rule, segmental wall motion can be safely assessed when the endocardial contour is clearly visualized for at least 50 % of its length. The 16-segment model meets the basic requirements of any reasonable segmentation: it is simple enough to be employed in practice; it has an anatomical basis; segments can be easily identified on the basis of obvious echocardiographic landmarks; there is good correspondence with the distribution of coronary arteries; and the model has stood the test of multicenter cooperative studies [3].


Left Ventricle Wall Motion Stress Echocardiography Interventricular Septum Septal Perforator 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Visser CA, Kan G, Meltzer R (eds) (1988) Echocardiography in coronary artery disease. Martinus Nijhoff, BostonGoogle Scholar
  2. 2.
    Edwards WD, Tajik AJ, Seward JB (1981) Standardized nomenclature and anatomic basis for regional tomographic analysis of the heart. Mayo Clin Proc 56: 479–497PubMedGoogle Scholar
  3. 3.
    Picano E, Landi P, Raciti M, Pingitore A, Sicari R, Vassalle C, Mathias W, Lowenstein J, Petix N, Gigli G, Bigi R, Salustri A, Heymann J, Mattioli R, Chiarandà G, Galati A, on behalf of the EPIC-EDIC study project (1995) The multicenter trial philosophy in stress echocardiography: lessons learned from the EPIC study. Eur Heart J 11 [Suppl]: 23–25Google Scholar
  4. 4.
    American Society of Echocardiography Committee on standards, subcommittee on quantitation of two-dimensional echocardiograms: Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I, Silverman AH, Tajik AJ (1989) Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echo 2: 358–367Google Scholar
  5. 5.
    Feigenbaum H (1986) Coronary artery disease. In: Feigenbaum H (ed) Echocardiography, 4th edn, Chap 6. Lea and Febiger, Philadelphia, pp 462–513Google Scholar
  6. 6.
    Feigenbaum H (1988) Exercise echocardiography. J Am Soc Echo 1: 161–166Google Scholar
  7. 7.
    Weyman AE (1982) Cross-sectional echocardiography. Lea and Febiger, PhiladelphiaGoogle Scholar
  8. 8.
    Vandenberg BF, Kerber RE (1988) Regional wall-motion abnormalities and coronary artery disease: prognostic implications. In: Kerber RE (ed) Echocardiography in coronary artery disease. Futura, Mount Kisco, NY, pp 67–80Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • Eugenio Picano
    • 1
  1. 1.Institute of Clinical PhysiologyCNRPisaItaly

Personalised recommendations